High Altitude Medicine and Physiology

Abstract

A larger format and fresh appearance mark a change to this third edition of High Altitude Medicine and Physiology. Anyone with an interest in altitude medicine will be drawn to this volume by the attractive and intriguing cover photograph of Mt Kongur. Those turning open that striking cover will be rewarded with what must be regarded as the definitive textbook of high-altitude medicine. Improvement over the previous 2 editions of High Altitude Medicine and Physiology extends well beyond the cover. Given the rapidly expanding literature relating to high-altitude medicine, the authors have done an impressive job of incorporating much of this new information. A number of new references have been added to this edition, although they are in no way comprehensive of the literature. The references are now conveniently grouped together in an appendix at the end of the book. More than 1500 scientific reports that appeared between 1995 and May 2000 were reviewed. This remarkable publishing achievement should not go unmentioned. For example, our work in Nepal on the use of ketamine anesthesia at altitude was performed in 1999 and published in 2000, yet appears in this textbook published in 2000. The text has been updated throughout. This change brings significant value to the new edition even for those in possession of a previous edition. The skillful weave of physiologic understanding and evidence supporting those explanations, along with practical advice to those serving in clinical situations, continues as the hallmark of the success of this reference book—not an easy task for a volume with such a broad and in-depth scope. Sections of the book have been shifted, and small changes in the grouping of sections into separate chapters have taken place. Three new chapters are presented. A chapter titled “Women, Children, and Elderly People at Altitude” addresses special issues regarding these groups. The addition to the chapter title of the phrase “Special Issues Regarding …” would be more accurate. A chapter on acclimatization is a welcomed and logical addition. The chapter “Other Conditions” is a catch-all for neurovascular disorders, eye conditions, altitude cough, and anesthesia. Remarkable in the overall degree of detail, occasional sections lack the depth of content that is hoped for in such a complete textbook. For example, pharmacokinetics and genetics do not reflect the growing interest in these areas. Although a text of high-altitude medicine and physiology, the related chapters pertaining to cold and heat exposure remain included, offering an added value for the reader. The cost of the book will diminish the demand for this edition as an essential replacement to previous editions on the bookshelf. But for those who can afford the cost, or who are looking to buy their first copy of the book, the purchase is certainly worthwhile. Those with limited financial resources may find that the 5-year turnaround for past new editions might lead them to wait for the possible 4th edition, which could be available as early as 2005. For anyone with a medical background and a detailed interest in high-altitude medicine, High Altitude Medicine and Physiology is the most comprehensive work available on the subject. But as an academic medical textbook, the utility of the book for individuals beyond the medical or biological disciplines would likely be a strain.